Long-term clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor combined with low molecular weight heparin in patients with acute coronary syndrome

Ju Han Kim, Myung Ho Jeong, Jay Young Rhew, Ji Hyun Lim, Kyung Ho Yun, Kye Hun Kim, Dong Koo Kang, Seo Na Hong, Sang Yeob Lim, Sang Hyun Lee, Yeon Sang Lee, Young Joon Hong, Hyung Wook Park, Weon Kim, Young Keun Ahn, Yong Moon, Jeong Gwang Cho, Jong Chun Park, Jung Chaee Kang

Research output: Contribution to journalArticle

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Abstract

Background: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. Methods and Results: One hundred and sixty patients (60.9+11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban+ heparin) and group IV (n=40: tirofiban+dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). Conclusions: Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.

Original languageEnglish
Pages (from-to)159-164
Number of pages6
JournalCirculation Journal
Volume69
Issue number2
DOIs
Publication statusPublished - 2005 Feb 1
Externally publishedYes

Fingerprint

tirofiban
Dalteparin
Integrin beta3
Platelet Glycoprotein GPIIb-IIIa Complex
Low Molecular Weight Heparin
Acute Coronary Syndrome
Heparin
Hemorrhage
Troponin
Unstable Angina
Platelet Activation
Percutaneous Coronary Intervention
Platelet Aggregation
Coronary Artery Bypass
Thrombosis
Transplants
Incidence

Keywords

  • Coronary disease
  • Heparin
  • Platelet aggregation inhibitors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor combined with low molecular weight heparin in patients with acute coronary syndrome. / Kim, Ju Han; Jeong, Myung Ho; Rhew, Jay Young; Lim, Ji Hyun; Yun, Kyung Ho; Kim, Kye Hun; Kang, Dong Koo; Hong, Seo Na; Lim, Sang Yeob; Lee, Sang Hyun; Lee, Yeon Sang; Hong, Young Joon; Park, Hyung Wook; Kim, Weon; Ahn, Young Keun; Moon, Yong; Cho, Jeong Gwang; Park, Jong Chun; Kang, Jung Chaee.

In: Circulation Journal, Vol. 69, No. 2, 01.02.2005, p. 159-164.

Research output: Contribution to journalArticle

Kim, JH, Jeong, MH, Rhew, JY, Lim, JH, Yun, KH, Kim, KH, Kang, DK, Hong, SN, Lim, SY, Lee, SH, Lee, YS, Hong, YJ, Park, HW, Kim, W, Ahn, YK, Moon, Y, Cho, JG, Park, JC & Kang, JC 2005, 'Long-term clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor combined with low molecular weight heparin in patients with acute coronary syndrome', Circulation Journal, vol. 69, no. 2, pp. 159-164. https://doi.org/10.1253/circj.69.159
Kim, Ju Han ; Jeong, Myung Ho ; Rhew, Jay Young ; Lim, Ji Hyun ; Yun, Kyung Ho ; Kim, Kye Hun ; Kang, Dong Koo ; Hong, Seo Na ; Lim, Sang Yeob ; Lee, Sang Hyun ; Lee, Yeon Sang ; Hong, Young Joon ; Park, Hyung Wook ; Kim, Weon ; Ahn, Young Keun ; Moon, Yong ; Cho, Jeong Gwang ; Park, Jong Chun ; Kang, Jung Chaee. / Long-term clinical outcomes of platelet glycoprotein IIb/IIIa inhibitor combined with low molecular weight heparin in patients with acute coronary syndrome. In: Circulation Journal. 2005 ; Vol. 69, No. 2. pp. 159-164.
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AU - Kim, Ju Han

AU - Jeong, Myung Ho

AU - Rhew, Jay Young

AU - Lim, Ji Hyun

AU - Yun, Kyung Ho

AU - Kim, Kye Hun

AU - Kang, Dong Koo

AU - Hong, Seo Na

AU - Lim, Sang Yeob

AU - Lee, Sang Hyun

AU - Lee, Yeon Sang

AU - Hong, Young Joon

AU - Park, Hyung Wook

AU - Kim, Weon

AU - Ahn, Young Keun

AU - Moon, Yong

AU - Cho, Jeong Gwang

AU - Park, Jong Chun

AU - Kang, Jung Chaee

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N2 - Background: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. Methods and Results: One hundred and sixty patients (60.9+11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban+ heparin) and group IV (n=40: tirofiban+dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). Conclusions: Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.

AB - Background: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. Methods and Results: One hundred and sixty patients (60.9+11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban+ heparin) and group IV (n=40: tirofiban+dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). Conclusions: Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.

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